Acute abdominal disorders in the paralysed patient

In the paralysed and sedated patient, acute abdominal diseases are difficult to diagnose. Clinical signs such as tenderness, rebound, guarding and rigidity are often misleading or absent and in the fully monitored, critically ill patient, the abdominal X-ray, ultrasound and CT scan may be associated with a high incidence of artifact abnormality. The acute abdominal disorders commonly found in the critically ill patient are listed, the diagnostic approach using standard clinical and investigational methods is considered, and the problems commonly encountered by the clinician are highlighted.